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Client Questionnaire:
Welcome and thank you for your interest in me coaching you! Please answer with complete honesty and as accurately as possible.
*SINCE THIS IS A FIRST COME, FIRST SERVE BASIS - PLEASE ONLY FILL OUT THIS QUESTIONNAIRE ONCE OR YOU WILL LOSE YOUR SPOT IN LINE.*
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First and Last Name:
*
Your answer
Email:
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Your answer
Age:
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Your answer
Height:
*
Your answer
Current Weight:
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Your answer
Goals (Check all that apply):
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Muscle Building
Weight and Fat Loss
Strength Building
Lifestyle Change
Healthy Food Habits
Required
Current Cardio:
*
Add in your sessions, how many minutes/intervals and the type of cardio.
Your answer
Current Lifting Regimen:
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Your answer
Current Nutrition Regimen:
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Your answer
Do you have any injuries or health conditions?
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Yes
No
Do you have any food allergies?
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Yes
No
List food allergies (or N/A):
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Your answer
Are you vegan or plant based?
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Yes
No
Current supplementation (or N/A):
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Your answer
What is your dieting/coaching history?
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Your answer
How often have you dieted for weight or fat loss over the last 5 years?
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Always
Often
Sometimes
Rarely
Never
What types of diets have you done?
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Your answer
Have you tracked your macros before?
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Yes
No
Other:
What does your daily schedule look like? (Work, school, gym, etc.)
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Your answer
While I get started, I will be limited on the amount of clients I take. If spots fill up, are you interested in being added to the waitlist?
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Yes
No
Other:
Are you more interested in 1:1 coaching or group coaching? (At this time I am only offering group coaching).
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1:1
Group
Either - I'm open.
Other:
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